Originally Posted by Raptor

Quick story: bmi > 35 (or other risk factors, but bmi > 35 is what will gather up 95%) will get you an assessment. If you need an assessment you will get spec sheet B. Read it and follow the instructions.

An assessment can be done by the AME (but the FAA doesn't recommend that), your PCP (personal care physician), or a board certified sleep specialist. The assessment will determine if you need a sleep study or not. Just because you are high risk and get spec sheet B doesn't mean you automatically get a sleep study. You only get a sleep study if the assessment finds you need one.

Only time will tell how well the FAA accepts assessments that determine one doesn't need a sleep study.

I have already heard about several AMEs who all are interpreting the guidance differently (and incorrectly), so it would be wise to be knowledgeable yourself by reading the AME guide linked above.